In the blogs on hypertension, I mentioned that atherosclerosis and cardiovascular disease are the result of inflammatory processes in the body leading to irregularities in the immune system, which then starts to destroy its own. Cardiovascular disease results. These processes are intimately connected to metabolic disease such as type 2 diabetes, which is driven by both inflammatory and auto-immune components. The drivers of this “cardiometabolic” risk are obesity and central adiposity (fat accumulation around the middle). These create insulin resistance which if unchecked creates type 2 diabetes and heart disease. Along the way, the body responds with dyslipidemia (abnormal cholesterol, LDL, HDL, triglycerides) and hypertension. The combination of these numerous risks that eventually lead to cardiovascular disease is known as the “metabolic” syndrome.
Obesity and central adiposity do give birth to insulin resistance. Adipocytes, or fat cells, are more than mere fat warehouses. These cells are endocrine organs which secrete a variety of hormones and cytokines which affect the metabolic machinery of the body by sending signals to the immune system. One of these cytokines is TNF alpha which drives several reactions creating a thrombotic (clotting) environment and the risk of stroke or heart attack! DECREASING OBESITY AND IMPROVING INSULIN SENSITIVITY MAY HAVE THE MOST SIGNIFICANT IMPACT ON CARDIOVASCULAR DISEASE IN THE NEXT 40 YEARS! And, it can be done WITHOUT drugs!
If you study the maps of obesity trends in the USA from 1990 to 2008 you will notice the rates are climbing. In 2008, greater than 30% of the population was considered obese. This is a lot of stress metabolically on the body and even more stress on the cost of health care! As BMI (body mass index, a measure of obesity) increases into overweight and obese areas it is noted that cholesterol increases, hypertension develops, triglycerides ( an indirect measure of insulin resistance) increase, glucose or blood sugar increases and HDL or “good” cholesterol decreases. These metabolic changes herald the onset of type 2 diabetes and heart disease which in many cases lead to death. Childhood obesity is also rising at an alarming rate. The CDC predicts that 1 out of 3 children born in the year 2000 will be diagnosed with diabetes within their lifetime. And as I have always stated, children born in the year 2000 and beyond will be the first generation of Americans to have a SHORTER life expectancy than that of their parents.
In the next post we will discuss non-pharmacologic ways to regulate and prevent insulin resistance.Type 2 diabetes can be prevented without drugs. And preventing this highly inflammatory disease will go a long way to reducing chronic disease and reducing health care costs!We need to reverse this trend. We need to address the obesity epidemic. We must diagnose insulin resistance early and understand the glycemic impact of foods. We can use diet, exercise and nutrition to improve insulin sensitivity. Improving glycemic control involves eating breakfast with balanced macronutrients (tune into the Giannotto Clinic YouTube channel on nutrition). We can reduce the glycemic impact of foods with fiber and plant nutrients. We can use insulin sensitizing nutraceuticals like alpha lipoid acid, chromium and cinnamon. And above all, we need to increase physical activity- ANY increase will benefit!
Contact the Giannotto Clinic for help with choosing a nutritional lifestyle.